Responsible for on-going analysis of plan effectiveness Work with data management team to triage and address any issues..., Mathematics, Management Science, Engineering, or other decision science Minimum 8 years pharmaceutical industry experience...
where necessary. The position will work with underwriting, finance, claims and IT departments as they will be involved with the.... Complete class analyses on programs to help maximize profitability Create dashboards in Power BI to make program data...
trust and empowerment through open access of information You are evidence-based and prioritize data and science over...-from eligibility, coding, and claims to collections, payer contracting, and regulatory compliance. You'll bring deep RCM domain...
, information, and data for administrative action. Schedules appointments and maintains department's calendar and advises CSPD team... the OHSU system. Arranges travel itinerary and accommodations. Prepares and submits travel and expense claims. Maintains...
, information, and data for administrative action. Schedules appointments and maintains department's calendar and advises CSPD team... the OHSU system. Arranges travel itinerary and accommodations. Prepares and submits travel and expense claims. Maintains...
Claims and remittance. The focus of this analyst will revolve around claims and billing workflows. You should be solid enough.... Assists Application Director in developing build timelines and project plans as communicated by leadership. 10. Performs...
to community-based organizations, and SSI or SSD application and appeal. Under the general supervision of the Director... reviewing, amending, and correcting submitted management data and forms from Contract Analysts while supervising them regarding...
development from the vast array of data sources maintained by Prisma and turning them into actionable insights. Tasked... with designing and implementing robust data models, analyzing data from diverse sources to identify metrics and KPIs that align...
. This position requires a dynamic pharmacist to be the expert on clinical issues, collaborating with the Director of Pharmacy... to create efficiencies. Support physician reviewers with necessary information for reviewing non-approvable claims and develop...
will report to the Director of PMO and ensure that vendors deliver services in alignment with contractual obligations, service... s operational requirements and international regulatory standards. Ensure vendors meet all regulatory, data privacy, cybersecurity...
and Experience PhD in economics, statistics, mathematics, data science, health policy, or a related quantitative field. Experience... care claims data, large-scale individual-level medical records, claims-based analyses, and data sets which contains 10...
. This position requires a dynamic pharmacist to be the expert on clinical issues, collaborating with the Director of Pharmacy... to create efficiencies. Support physician reviewers with necessary information for reviewing non-approvable claims and develop...
guidance of Director and Partners Perform analysis using Excel, PowerPoint and other data visualization tools to produce client... project reviews to evaluate percentage of completion, probability of recovery for change orders and claims, reasonableness...
claims to ensure timely payments Analyzes data to identify trends, inefficiencies, and lost revenue, producing reports...Job Title Revenue Cycle Manager - Clinical Agency Texas A&M University Health Science Center Department Clinic Str...
. This position requires a dynamic pharmacist to be the expert on clinical issues, collaborating with the Director of Pharmacy... to create efficiencies. Support physician reviewers with necessary information for reviewing non-approvable claims and develop...
. Job Description Reporting Relationships: Reports to Manager/Director; may be an individual contributor or manage a team of less than 4..., claims, attorneys, accountants, financial advisors, and government and regulatory agencies. Analyzes various regulations...
for predictive analytics. Experience analyzing health care claims data or other administrative data sources. Experience... best available evidence. The candidate will serve as a Research Scientist, supporting the collection and reporting of quality data and ongoing...
, collaborating with the Director of Pharmacy and other staff pharmacists. The role involves designing, implementing, maintaining...-approvable claims and develop Decision Tree review processes when applicable. Ensure URAC accreditation is maintained by working...
business requirements for API solutions integrating Guidewire policy center, ensuring seamless data flow and system... processes and data transformation. Perform API validation, analyzing JSON based API payloads, troubleshooting data integrations...
on clinical issues, collaborating with the Director of Pharmacy and other staff pharmacists. The role involves designing... for reviewing non-approvable claims and develop Decision Tree review processes when applicable. Ensure URAC accreditation...